"I have no illusions about the danger the world is in, because we are dealing with a virus that is unpredictable, firmly entrenched and continuing to spread," Shigeru Omi said, noting attempts so far to bring it under control in Southeast Asia have failed.

by Steve MitchellSenior Medical CorrespondentWashington (UPI) Oct 14, 2005The recent announcement that a strain of bird flu had spread to Romania and Turkey has heightened long-standing concerns about a global pandemic of the deadly virus, but a World Health Organization official said Friday the international community might be able to contain the pathogen.

"I believe that the momentum that is now building up will give us a chance to change the course of history and head off a pandemic caused by the H5N1 virus," Shigeru Omi, the WHO's regional director for the Western Pacific, said during a news conference in Manila, Philippines.

"In the past few weeks, some of the world's wealthiest nations have stepped forward to join us in the struggle" to ward off bird flu, Omi said. "One of the biggest coalitions in the history of public health is now taking shape, bringing together rich and poor nations, donor agencies, scientists, the business community and bodies such as the World Health Organization and those in animal health."

The H5N1 strain of bird flu has killed approximately 60 people, but so far it appears to have exhibited only limited or no capability to pass from person to person. Disease experts worry, however, the virus could mutate and adapt to humans, leading to a global pandemic that could kill millions.

Omi's remarks came as scientists reported a strain of the virus isolated from a Vietnamese girl who was infected in February has resisted the anti-viral drug oseltamivir, known by its trade name, Tamiflu. The girl recovered, but the finding raises concerns oseltamivir might be ineffective in combating an outbreak of bird flu in humans.

Yoshihiro Kawaoka, of the University of Tokyo, and colleagues report the Tamiflu result in the Oct. 20 issue of Nature. The journal's editors said they have released the study early due to its importance to public health.

The Vietnamese case constitutes a concern, because the United States and other countries are stockpiling Tamiflu to prepare for a global outbreak of bird flu if it should develop, and they plan to rely heavily on the drug. The United States already has stockpiled approximately 12 million to 13 million courses of Tamiflu.

The viral strain obtained from the girl, however, did succumb to another anti-viral called Relenza (zanamivir).

"It could be useful to stockpile zanamivir as well as oseltamivir in the event of an H5N1 influenza pandemic," Kawaoka's team concluded.

"We've been watching for this change (in the virus)," Kawaoka, also a professor at the University of Wisconsin-Madison School of Veterinary Medicine, said in a statement. "This is the first (case of resistance to anti-viral medications), but we will see others. There's no question about it."

The resistance may have developed after the girl was given a prophylactic dose of oseltamivir. Kawaoka said health officials should recommend only therapeutic dosages of the drug be given to help avoid resistance development.

The circumstances surrounding the case also indicate the girl may have contracted bird flu from her brother -- rather than direct contact with infected birds -- raising the possibility the virus is mutating and becoming more adept at jumping from person to person.

In addition to the threat to human lives, the virus poses economic concerns, because it can disrupt commercial poultry operations. Millions of birds either have been killed by influenza or culled in an effort to stop its spread, and countries have banned poultry imports from affected regions.

Despite his enthusiasm that a bird-flu pandemic could be prevented, Omi said the virus still poses a threat to the world.

"I have no illusions about the danger the world is in, because we are dealing with a virus that is unpredictable, firmly entrenched and continuing to spread," he said, noting attempts so far to bring it under control in Southeast Asia have failed.

The international community pledged nearly $20 million this week to aid several Asian nations hit by bird flu, including Cambodia, the People's Democratic Republic of Laos, Indonesia and Vietnam, but Omi said it will take more than international assistance to curtail the virus. The affected countries must do their part and share the samples of the virus they are collecting from people and birds.

"Without those samples, we cannot know if the virus is mutating and if it is any closer to tipping the world into the unknown," he said.